Alternative Techniques of Ligament Reconstruction in Patients with Combined Cruciate and Postero-lateral Corner Injuries of the Knee

封面


如何引用文章

全文:

详细

Background. In recent years, there has been an increase in the number of the patients with multiligament knee injuries. A significant proportion of unsatisfactory outcomes of such injuries treatment is associated with this injury features and the objective difficulties of its surgical correction. This determines the need for searching the optimal methods of diagnosis and treatment of such an injury. The purpose of this study was to compare the results of surgical treatment of the patients with multiligament knee injury, including the injury of the ligament-tendon complex of the knee posterolateral angle with two different techniques. Materials and Methods. The study included 51 patients with multiligament knee injury undergone the surgical treatment from 2007 to 2019. The average age of the patients was 32.1±9.2 years. The patients were divided into two groups. The patients of the main group (24 patients) underwent reconstruction of the cruciate ligaments and the main structures of the posterolateral angle: the fibular collateral ligament, the popliteofibular ligament, and the popliteus tendon. The patients of the comparison group (27 patients) underwent the reconstruction of the cruciate ligaments supplemented with isolated fibular collateral ligament grafting. The results obtained were evaluated clinically using the Lysholm scale (1982), by determining the subjective assessment of treatment outcomes, and by functional X-ray and MRI. The results of the treatment were studied in all injures: in the main group in 9 months, in the comparison group on average in 16 months after the surgery (from 9 to 43 months). Results. The use of the developed diagnostic and surgical methods made it possible to improve the clinical and functional results by the Lysholm scale: the main group 82 [70; 86] points vs the control group 68 [64; 76] points (p = 0.003). The II degree residual lateral instability was observed in 2 patients of the main group and in 7 patients of the control. 19 (79.2%) patients in the main group and 18 (66.7%) in the control were satisfied with treatment outcomes according to the scale of subjective assessment. There were no patients who rated the result of their treatment as “good” in the both groups. Conclusion. The practical employment of the proposed modification of the fibular collateral ligament grafting by the LaPrade in the patients with multiligament knee injury makes it possible the statistically significant improvement of the treatment functional results after the reconstructive surgery in the medium term (9 months) compared with the patients undergone isolated fibular collateral ligament grafting. The unsatisfactory results of the treatment caused by the severity and morphological features of the injuries. They require further study, as well as the improvement of the surgical techniques.

作者简介

V. Khominets

Kirov Military Medical Academy

Email: khominets_62@mail.ru
ORCID iD: 0000-0001-9391-3316

Vladimir V. Khominets — Dr. Sci. (Med.), Head of the Department and Clinic of Military Traumatology and Orthopedics

St. Petersburg

俄罗斯联邦

A. Kudyashev

Kirov Military Medical Academy

Email: a.kudyashev@gmail.com
ORCID iD: 0000-0002-8561-2289

Alexey L. Kudyashev — Dr. Sci. (Med.), Deputy Head, Department of Military Traumatology and Orthopaedics

St. Petersburg

俄罗斯联邦

I. Bazarov

Kirov Military Medical Academy

编辑信件的主要联系方式.
Email: dok055@yandex.ru
ORCID iD: 0000-0002-4708-493X

Ivan S. Bazarov — senior resident, Clinic of Military Traumatology and Orthopedics

St. Petersburg

俄罗斯联邦

A. Grankin

Kirov Military Medical Academy

Email: Aleksey-Grankin@yandex.ru
ORCID iD: 0000-0002-4565-9066

Alexey S. Grankin — Cand. Sci. (Med.), Head of Trauma Department, Clinic of Traumatology and Orthopedics

St. Petersburg

俄罗斯联邦

O. Rikun

Kirov Military Medical Academy

Email: rikoleg@yandex.ru
ORCID iD: 0000-0002-2027-8996

Oleg V. Rikun — Cand. Sci. (Med.), Associated Professor, Department of Military Traumatology and Orthopedics

St. Petersburg

俄罗斯联邦

M. Rezvantsev

Kirov Military Medical Academy

Email: rmv_spb@mail.ru
ORCID iD: 0000-0001-5649-8440

Mikhail V. Rezvantsev — Cand. Sci. (Med.), Deputy Head, Educational and Methodical Department

St. Petersburg

俄罗斯联邦

R. Fedorov

Kirov Military Medical Academy

Email: roman.doc83@yanex.ru
ORCID iD: 0000-0003-3509-4791

Roman A. Fedorov — Lecture, Department of Military Traumatology and Orthopaedics

St. Petersburg

俄罗斯联邦

参考

  1. Geeslin A.G., LaPrade R.F. Location of bone bruises and other osseous injuries associated with acute grade III isolated and combined posterolateral knee injuries. Am J Sports Med. 2010;38(12):2502-2508. doi: 10.1177/0363546510376232.
  2. Hopper G.P., Heusdens C.H.W., Dossche L., Mackay G.M. Posterolateral corner repair with suture tape augmentation. Arthrosc Tech. 2018;7:e1299-e1303. doi: 10.1016/j.eats.2018.08.018.
  3. Kennedy M.I., Bernhardson A., Moatshe G., Buckley P.S., Engebretsen L., LaPrade R.F. Fibular collateral ligament/ posterolateral corner injury: When to repair, reconstruct, or both. Clin Sports Med. 2019; 38(2):261-274. doi: 10.1016/j.csm.2018.11.002.
  4. Baker C.L., Norwood L.A., Hughston J.C. Acute posterolateral rotatory instability of the knee. J Bone Joint Surg Am. 1983;65(5):614-618.
  5. Pallis M.P., Lanzi J.T. Jr., Garcia E.J., William W.M., Chan A.G. Multiple-Ligament Knee Injuries in the United States Military Active-Duty Population. In: The Multiple Ligament Injured Knee. Cham : Springer; 2019. p. 489-494.
  6. Peskun C.J., Chahal J., Steinfeld Z.Y., Whelan D.B. Risk factors for peroneal nerve injury and recovery in knee dislocation. Clin Orthop Relat Res. 2012;470(3):774-778. doi: 10.1007/s11999-011-1981-0.
  7. Schenck Jr. R.C. Classification of knee dislocations. Oper Techniq Sports Med. 2003;11(3):193-198. doi: 10.1053/otsm.2003.35918
  8. Grawe B., Schroeder A.J., Kakazu R., Messer M.S. Lateral collateral ligament injury about the knee: anatomy, evaluation, and management. J Am Acad Orthop Surg. 2018;26(6):e120-e127. doi: 10.5435/JAAOS-D-16-00028.
  9. Arciero R.A. Anatomic posterolateral corner knee reconstruction. Arthroscopy. 2005;21(9):1147. doi: 10.1016/j.arthro.2005.06.008.
  10. Moatshe G., Dean C.S., Chahla J., Serra Cruz R., LaPrade R.F. Anatomic fibular collateral ligament reconstruction. Arthrosc Tech. 2016;5(2):e309-e314. doi: 10.1016/j.eats.2016.01.007.
  11. Рикун О.В., Хоминец В.В. Лечение повреждений и заболеваний коленного сустава у военнослужащих. СПб.: Полторак; 2020. С. 159-185.
  12. O’Malley M.P., Pareek A., Reardon P., Krych A., Stuart M.J., Levy B.A. Treatment of Peroneal Nerve Injuries in the Multiligament Injured/ Dislocated Knee. J Knee Surg. 2016;29(4):287-292. doi: 10.1055/s-0035-1570019.
  13. Jarret M.W., Nicholas P.R., John G.E., Nicholas G.M., Peter D.L. A systematic review of peroneal nerve palsy and recovery following traumatic knee dislocation. Knee Surg Sports Traumatol Arthrosc. 2015;23(10):2992-3002. doi: 10.1007/s00167-015-3676-7
  14. Stannard J.P., Brown S.L., Farris R.C., McGwin G. Jr., Volgas D.A. The posterolateral corner of the knee: Repair versus reconstruction. Am J Sports Med. 2005;33(6):881-888. doi: 10.1177/0363546504271208.
  15. Heitmann M., Akoto R., Krause M., Hepp P., Schöpp C., Gensior T.J. et al. Management of acute knee dislocations: anatomic repair and ligament bracing as a new treatment option-results of a multicentre study. Knee Surg Sports Traumatol Arthrosc. 2019;27(8):27102718. doi: 10.1007/s00167-018-5317-4.
  16. Fanelli G.C. (ed.). The multiple ligament injured knee: a practical guide to management. Springer; 2004. рр. 211-226
  17. LaPrade R.F., Johansen S., Wentorf F.A. An Analysis of an Anatomical Posterolateral Knee Reconstruction: An In Vitro Biomechanical Study and Development of a Surgical Technique. Am J Sports Med. 2004;32(6):14051414. doi: 10.1177/0363546503262687.
  18. LaPrade R.F., Nicholas N.D., Cram T.R., Cinque M.E., Kennedy M.I. Controlled Early Postoperative Weightbearing Versus Nonweightbearing After Reconstruction of the Fibular (Lateral) Collateral Ligament: A Randomized Controlled Trial and Equivalence Analysis. Am J Sports Med. 2018; 46(10):2355-2365. doi: 10.1177/0363546518784301.
  19. Shane C., Ridley T.J., Mark A.M., Yubo G., Brian R.W., Annunziato A., Matthew J.B. Surgical treatment of multiligament knee injuries. Knee Surg Sports Traumatol Arthrosc. 2015;23(10):2983-2991. doi: 10.1007/s00167-014-3451-1.
  20. LaPrade R.F., Terry G.S. Injuries to the Posterolateral Aspect of the Knee. Association of anatomic injury patterns with clinical instability. Am J Sports Med. 1997;25(4):433-438. doi: 10.1177/036354659702500403.
  21. Neri T., Myat D., Beach A., Parke D.A. Multiligament Knee Injury Patterns, Outcomes, and Gait Analysis. Clin Sports Med. 2018; 38(2):235-246. doi: 10.1016/j.csm.2018.11.010.
  22. Vavken P., Proffen B., Peterson C., Fleming B.C., Machan J.T., Murray M.M. Effects of suture choice on biomechanics and physeal status after bioenhanced anterior cruciate ligament repair in skeletally immature patients: a largeanimal study. Arthroscopy. 2013;29(1):122-132. doi: 10.1016/j.arthro.2012.07.006.
  23. LaPrade R.F., Heikes C., Bakker A.J., Jakobsen R.B. The reproducibility and repeatability of varus stress radiographs in the assessment of isolated fibular collateral ligament and grade-III posterolateral knee injuries. An in vitro biomechanical study. J Bone Joint Surg Am. 2008;90(10):2069-2076. doi: 10.2106/JBJS.G.00979.
  24. Sanders T.L., Johnson N.R., Levy N.M., Cole P.A. Jr., Krych A.J., Stuart M, Levy B.A. Effect of Vascular Injury on Functional Outcome in Knees with Multi-Ligament Injury: A Matched-Cohort Analysis. J Bone Joint Surg Am. 2017;99(18):1565-1571. doi: 10.2106/JBJS.16.01540.
  25. Westermann R.W., Marx R.G., Spindler K.P., Huston L.J.; MOON Knee Group, Amendola A. et al. No Difference Between Posterolateral Corner Repair and Reconstruction With Concurrent ACL Surgery: Results From a Prospective Multicenter Cohort. Orthop J Sports Med. 2019;7(7):2325967119861062. doi: 10.1177/2325967119861062.
  26. Hegyes M.S., Richardson M.W., Miller M.D. Knee dislocation. Complications of nonoperative and operative management. Clin Sports Med. 2000;19(3):519-543. doi: 10.1016/s0278-5919(05)70222-2.
  27. Kupczik F., Schiavon M.E.G., Vieira L.A., Tenius D.P., Fávaro R.C. Knee Dislocation: Descriptive Study of Injuries. Rev Bras Ortop. 2013;48(2):145-151. doi: 10.1016/j.rboe.2012.10.002.
  28. Robertson A., Nutton R.W., Keating J.F. Dislocation of the knee. J Bone Joint Surg Br. 2006;88(6):706-711. doi: 10.1302/0301-620X.88B6.17448.
  29. Arom G.A., Yeranosian M.G., Petrigliano F.A., Terrel R.D., McAlister D.R. The changing demographics of knee dislocation: a retrospective database review. Clin Orthop Relat Res. 2014;472(9):2609-2614. doi: 10.1007/s11999-013-3373-0.
  30. Strobel M.J., Schulz M.S., Petersen W.J., Eichhorn H.J. Combined anterior cruciate ligament, posterior cruciate ligament, and posterolateral corner reconstruction with autogenous hamstring grafts in chronic instabilities. Arthroscopy. 2006;22(2):182-192. doi: 10.1016/j.arthro.2005.11.001.
  31. Huicheng F., Hunwu X., Sun J., Chang Q., Yu F., Jian C. Treatment of multiple knee-ligament injury with calcaneal tendon allograft using arthroscopy. Biomed Res. 2017;28(5):2310-2314.
  32. Dekker T.J., Guerrero E.M. Technical Aspects of Addressing Multiligament Knee Instability. Duke Orthop J. 2016;6(1):47-53. doi: 10.5005/jp-journals-10017-1069.
  33. Delee J.C., Riley M.B., Rockwood C.A. Acute posterolateral rotatory instability of the knee. Am J Sports Med. 1983;11:199-207. doi: 10.1177/036354658301100403.
  34. Marom N., Ruzbarsky J.J., Roselaar N., Marx R.G. Knee MLI Injuries Common Problems and Solutions. Clin Sports Med. 2018;37(2):281-291. doi: 10.1016/j.csm.2017.12.011.
  35. van der List J.P., DiFelice G.S. Preservation of the Anterior Cruciate Ligament: A Treatment Algorithm Based on Tear Location and Tissue Quality. Am J Orthop (Belle Mead NJ). 2016;45(7):E393-E405.
  36. Levy B.A., Dajani K.A., Morgan J.A., Shah J.P., Dahm D.L., Stuart M.J. Repair versus reconstruction of the fibular collateral ligament and posterolateral corner in the multiligament-injured knee. Am J Sports Med. 2010;38(4):804-809. doi: 10.1177/0363546509352459.
  37. Woodmass J.M, Sanders T.L., Johnson N.R., Wu I.T., Krych A.J, Stuart M.J., Levy B.A. Posterolateral Corner Reconstruction using the Anatomical Two-Tailed Graft Technique: Clinical Outcomes in the Multiligament Injured Knee. J Knee Surg. 2018;31(10):1031-1036. doi: 10.1055/s-0038-1632377.
  38. Fanelli G.C., Orcutt D.R., Edson C.J. The multipleligament injured knee: evaluation, treatment, and results. Arthroscopy. 2005;21(4):471-486. doi: 10.1016/j.arthro.2005.01.001.

补充文件

附件文件
动作
1. JATS XML
下载

版权所有 © ,


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 82474 от 10.12.2021.


##common.cookie##